Hospice: More than saying goodbye

Friday

Apr 18, 2014 at 4:34 PM

Statistically, the average person who enters hospice care uses its services for about two weeks before death occurs.

By Carla BarberStaff Writer

Statistically, the average person who enters hospice care uses its services for about two weeks before death occurs.Darla Wilson, executive director of Hospice and Home Care of Reno County/McPherson, thinks that’s a shame.“Statistics show that people who enter hospice usually live longer than those who don’t, because of the multi-disciplinary care,” Wilson said. “They live longer and display a better quality of life because their needs are met.” Medically, physically, spiritually, mentally, socially and emotionally, patients are cared for by a team of hospice staff who meet the patient on their terms.“If you want a good end of life, it’s a choice you can make,” Wilson said.She said the reason the average time a patient spends in hospice care is so short is because they aren’t called in until the very end, often by referral from a hospital or physician. “No one ever wants to think about hospice, about the death of a loved one,” Wilson said, “but a conversation about what they want, early on, may make all the difference in the quality of life they experience toward the end of their lives.”

Help for familiesIt’s not just patients who benefit from hospice services. Their families are saved a considerable amount of stress worrying about the amount of care given, the ability of a parent to live alone or the caregiver’s capabilities.“We meet people where they are,” Wilson said. “If they are in a nursing home, we go there. If they are in their own home, they may choose to try to remain there until that just isn’t feasible anymore. And if and when they decide a change is necessary, we can help make that happen.”Most people are aware that hospice services provide support for patients facing end-of-life illnesses, allowing their families to focus on spending quality time with their loved one rather than on care-giving details, but the meaning of the phrase, “end-of-life,” may be surprising. “Terminal doesn’t mean immediate,” Wilson said. “Just incurable. An illness may be long-term. With hospice, some sort of time frame is expected, but honestly, nobody knows when death will occur.“The beauty of the home health aspect of hospice is that we see the patient regularly and document decline, so we know how the patient is doing. We don’t necessarily need x-rays or lab work to know what stage we’re in when dealing with a particular disease. We can tell by how much they’re sleeping or eating, or their ability to hold a thought or carry on a conversation.“We have to requalify patients periodically, based upon their digression,” Wilson said. “A patient may stay in hospice for a year or more, if their illness continues to indicate a downward turn.“Patients coming into our services with only two weeks left: That’s not what we want, but what happens as the patient or family loses their grip on control and has nowhere else to turn. “The most important message I can put out there about hospice is that we can help in many ways if they’ll just start the conversation with us sooner. Quite often, those calls come at the very end because families just don’t know what else to do.“We can help almost anyone who calls us, whether with our services or by referrals to private duty nursing or with a county program.”

Qualifying criteriaAdmission for home health services requires meeting admission criteria established by Medicare, Medicaid or the patient’s insurance provider.All services must be ordered and approved by the individual’s physician and, if certifying a patient as eligible for Medicare home health services, must see the patient, though a nonphysician practitioner may meet this requirement if working for or with the physician.The patient must need a skilled primary service; services ordered must be reasonable and medically necessary for the treatment of the patient’s illness or injury. Skilled nursing and/or home health services must be provided on an intermittent or part-time basis unless the skilled need is therapy.The patient or their family must desire services for the patient’s care, and the patient’s home must be adequate for safe and effective care. The patient must be homebound, defined by a considerable and difficult effort required to leave the home. Only brief and infrequent sojourns from the home are allowed.

Allowing for griefHospice also supports the family after their loss with phone calls and visits, as well as the opportunity to attend bereavement sessions, workshops and/or memorial events. Hospice and Home Care of Reno County/McPherson keeps in contact with the bereaved for 15 months after they experience a loss.